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Individual

MR. KEVIN MACKELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
23 OCEAN AVE, PORTLAND, ME 04103-5740
(207) 370-2212
Mailing address
23 OCEAN AVE, PORTLAND, ME 04103-5740
(207) 370-2212

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT4382
ME

Other

Enumeration date
11/22/2010
Last updated
11/22/2010
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